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American Society for Microbiology Bacterial Hand Contamination and Transfer after Use of Contaminated Bulk-Soap-Refillable Dispensers. Another reason not to refill bulk soap or antiseptic dispensers. Because of this is is particularly important to use single dose skin preparation solutions, as bulk dispensers post known problems.
Double pouching for sterile presentation? ATP use in CS?
by Ray Taurasi
Q The OR requires that Sterile Processing double peel pouches all items sent to them. They claim this is essential to allow for sterile presentation to the sterile field. I cannot find anything in AAMI or AORN recommendations stating this is necessary. I find it strange that they have no issues with commercially prepared items they use from manufacturers that are all single packaged. Why should there be different packaging standards for items sterilized in-house versus commercially sterilized items?
A There are no AAMI or AORN recommendations that state you must double peel pouch items for use in the Operating Room. Both AORN and AAMI state that you should follow the manufacturer’s IFUs for any packaging materials. Their recommendations also advise that if a hospital chooses to double peel pouch they must be sure that the manufacturer has validated their pouches for double pouching.
In light of a number of high-profile recalls of contaminated alcohol prep products in the last several years, the Food and Drug Administration (FDA) is currently weighing whether or not to require sterility of patient skin prep products, specifically items such as alcohol prep pads used for injections, but it is not ruling out other surgical prep products.
On Dec. 12, 2012, the FDA held a hearing to receive expert testimony and public comment on how to address microbial contamination of these patient preoperative skin preparation drug products. It is a step in the ongoing investigational process that the agency is undertaking to determine issues related to sterility impacted by manufacturing processes.
An FDA spokesperson says that the panel members and FDA’s working group have received the submissions from the hearing and have been deliberating. FDA’s working group will be ready to make new recommendations in the coming months. The spokesperson adds that FDA’s working group has been soliciting clinician feedback from the FDA’s federal partners and other public health organizations, and that the agency will be ready to make new recommendations in the coming months.
Currently, patient preoperative skin preparations are not required to be sterile, since bacteria can contaminate these products at the time of manufacture or during product use. But because contaminated patient preoperative skin preparations have been associated with clinical infections and adverse outcomes, the FDA is exploring certain scientific and product-use issues related to patient preoperative skin preparations.
Patient preoperative skin preparations are over-the-counter (OTC) topical antiseptic drug products used to reduce the number of bacteria on the skin prior to medical procedures or injections. Although they are marketed predominantly to healthcare facilities, the use of these products extends beyond the healthcare facility setting.
A gravity displacement (class N) steam sterilization process can not reliably remove gases from hollow or porous items, resulting in areas that do not get sterilized, and the failure of the load. They should not be used for body jewelry, needles, tattoo tubes or textiles.
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Effects of Non-Condensable Gases (NCGs) on Steam Sterilisation Processes
steam sterilisation process
non-condensable gases (NCGs)
process challenge device (PCD)
The dangers posed by non-condensable gases (NCGs) in steam sterilisation processes have long been underestimated. Biological indicators, or the best chemical indicators on the market, do not signal the presence of a NCG content of up to 10% in a sterilisation process so long as there is mixing of steam and NCGs in the sterilisation chamber.
Water quality; staining of sterile packaging; soil detection devices
by Ray Taurasi
Q I work in a small rural hospital in New Hampshire. We only have one OR and one sterilizer and no automated washers. All of our instruments and other reprocessable items are manually cleaned. I have noticed at times, especially during the winter months, our tap water has a cloudy color. Since we use tap water to clean our instruments and to mix with our chemical disinfectants, I was wondering if the water is safe to use or if it can damage our instruments.
A In the winter time in cold regions such as New Hampshire, the water coming into the hospital is extremely colder than the inside temperature and your water may have a milky or cloudy appearance. The reason for this is that cold water holds more oxygen than warmer water does.
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Can unused wrapped items be re-sterilized reusing the original wraps?
When unused sterile instrument sets are returned from the OR or patient floors our policy is to re-sterilize the sets. Since these were unopened we inspect the wrap to be sure there are no holes, replace the tapes and labeling and re-sterilize the item.
Can we label sterilization packages with a Sharpie brand marker?
Our staff used to label all of our cardiovascular sets and supplies with a red Sharpie brand permanent marker and we would use a black Sharpie for all other items. This provided a quick and easy method to visually identify these special critical items. The labeling was restricted to the autoclave tape on the outside of wrapped packages and the film side of peel pouches.
Interesting lead: The Certification Board for Sterile Processing and Distribution, Inc. (CBSPD), formerly the NICHSPDP, is a non-profit Certification Board which plans, develops and administers competency-based “International” certification examinations for personnel performing cleaning, disinfection, sterilization and inventory management activities, regardless of the setting. via About the CBSPD, Inc..
via Case Medical Inc. CASE ACADEMY ONLINE DESCRIPTION DOWNLOAD BASICS OF DECONTAMINATION – TUTORIAL CASDF001 BASICS OF DECONTAMINATION GLOSSARY CASDF001g BASICS OF DECONTAMINATION POST-TEST ANSWER KEY CASDF001a BASICS OF PACKAGING – TUTORIAL CASDF002 BASICS OF PACKAGING GLOSSARY CASDF002g BASICS OF PACKAGING POST-TEST ANSWER KEY CASDF002a BASICS OF STERILIZATION – TUTORIAL CASDF003 BASICS OF STERILIZATION – GLOSSARY … Read more Educational materials for Decontamination, Packaging and Sterilization – Case Medical Inc